I am an orthopedic spine surgeon who specializes in complex spinal surgery. I perform operations for scoliosis, kyphosis, and spondylolisthesis in adults and children. I also deal with fractures, infections, tumors, and patients who have had prior failed spine surgery. Over my more than 25 years of practice I have learned that only identifiable structural problems with matching symptoms respond to surgery. Structured rehabilitation adds tremendous value to spine care and can often help patients completely avoid surgical intervention. I have been instrumental in assembling a strong team with a wide depth of experience to minimize your pain and maximize your function.

Personal Interests

In the process of working with my patients who have chronic pain, I have discovered that stress is a significant factor which aggravates pain. I have been active in developing stress management strategies to present both in and out of my practice. My hobbies include snow skiing, golf, weight training, bird watching, and attempting to learn Italian.

I was surprised to find out that one of my female patients was actually a male. Not exactly. She had Androgen Insensitivity Syndrome (AIS). She was severely bullied, which is a common theme amongst my patients. Here is story.

This post is an excerpt from a workshop participant that I put on at the Omega Institute in 2013. We witnessed a remarkable turnaround in mood and pain in the course of just a week. Sharing seemed to be a major contributing factor to the success of the seminar.

Chronic pain is associated with anxiety and frustration. Consquently, your mind will continue to be filled with racing thoughts regardless of your attempts to slow them down. Shifting off of these pathways with simple mindfulness tools is an effective and necessary strategy.

I will never forget my first holiday season as an internal medicine resident in Spokane, WA. I learned that the holidays are a nightmare for the medicine service, especially the GI service. Many people don't take their medication during the holidays. The GI service is the worst in that patients with liver disease often drink more and develop major bleeding in their gut. People are depressed and the stress of the holidays puts them over the edge.

We had a resident’s clinic once a week. One of my favorite patients was an 80 year-old gentleman who was as nice of a person as you could meet. He had some moderate lung disease but otherwise was fairly healthy. He was admitted to the hospital on Christmas Eve with respiratory failure. It did not make sense to any of us, as his lung disease was not that severe. We had a whole team working intensely to solve the puzzle. It did not matter. He died two days later. During the course of the hospitalization I found out that his son who lived in Seattle had not invited him over for Christmas and he had become despondent. I have since learned that the will to die is as strong as the will to live.

My descent into loneliness

I could not figure this increase in illness and depression over the holidays for many years – until I descended into my own anxiety-driven depression and chronic pain. There were many ...

I have noticed this year that many patients with significant structural anatomic problems will improve or resolve their symptoms without surgery after engaging in a self-directed structured approach. It appears that as the nervous system calms down that the pain threshold rises.

Surgical decision-making

The barometer I use before I help patients make the final decision about whether to have surgery is whether they are sleeping well and their anxiety levels have dropped under a 5 on a scale of 10. My experience with performing surgery on a patient with a “fired up” nervous system has consistently been less than satisfactory. Pain control is difficult and even the longer-term results are marginal. There is often still a significant amount of residual pain.